Laughter therapy and anxiety relief in hospitalized children: evidence and applications

Abstract

Childhood hospitalization can trigger significant emotional repercussions, with anxiety being one of the most frequent manifestations in this context. Therefore, non-pharmacological interventions focused on humanizing care have been explored as complementary strategies to minimize the psychological suffering of children. In this scenario, laughter therapy, frequently associated with hospital clown therapy, has been investigated for its potential to promote emotional well-being and improve the hospitalization experience. This study aimed to analyze the scientific evidence on the effectiveness of laughter therapy in relieving anxiety in hospitalized children. This is an integrative literature review, conducted in six methodological steps. The search was performed in the PubMed/MEDLINE and Virtual Health Library (VHL) databases, using controlled descriptors and Boolean operators. Articles published between 2015 and 2025, in Portuguese, English, and Spanish, available in full text and related to the application of laughter therapy in pediatric hospital settings, were included. The results demonstrated that laughter therapy is associated with a significant reduction in anxiety, stress, and pain in hospitalized children, especially in pre-operative situations, invasive procedures, and pediatric ward admissions. In addition to emotional benefits, some studies have identified positive physiological effects, such as reduced cortisol levels and increased oxytocin, related to decreased stress and the promotion of well-being. A favorable impact on the interaction between children, families, and healthcare professionals was also observed, contributing to a more welcoming hospital environment. Despite the methodological heterogeneity among the studies, the evidence suggests that laughter therapy represents a promising complementary strategy, capable of promoting the humanization of care and improving the child's adaptation to the hospital environment.